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Soundbites from the American Academy of Actuaries' Health Practice Council Activities
December 2010, HHS released interim final regulations (IFRs) to implement the MLR requirements under ACA. In ... submitted comments1 addressing technical aspects of the IFRs to improve clarity and internal consistency, including ...- Authors: Heather E Jerbi, Tim M Mahony
- Date: May 2011
- Competency: Communication>Written communication; Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Actuarial Profession>Professional associations; Health & Disability; Public Policy
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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
Service The 2012 Part D summary rating consists of 17 individual measures for a Medicare Advantage Prescription ... Prescription Drug (MAPD) plan and the same 17 measures for a PDP, which are categorized into four separate ...- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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An Actuarial Model to Improve Health and Reduce Costs
unnecessary if the underlying cause is addressed.17 The clinical, scientific and historical evidence ... icle.jsp#.WVj0r7ldnIU (accessed June 30, 2017). 17 James Craner, Hypertension: A Silent Dietary Disease ...- Authors: Ken Beckman
- Date: Oct 2017
- Competency: Leadership>Thought leadership; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Chronic health management - Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Medicare Advantage risk scores – Are you competitive?
Medicare Advantage risk scores – Are you competitive? What you need to know about risk scores to be ... findings include: OCTOBER 2018 HEALTH WATCH | 17 • The average number of HCCs varies meaningfully ...- Authors: Corey Berger
- Date: Oct 2018
- Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Social Insurance>Medicare
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Bariatric Surgery Holds Promise for Patients and for Payors
Bariatric Surgery Holds Promise for Patients and for Payors An economic analysis of bariatric surgery ... prior to surgery and afterwards for an average of 17 months for the bariatric group and 18 months for ...- Authors: John Dawson, Pierre-Yves Cremieux, Arindam Ghosh
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Economics>Health economics; Experience Studies & Data; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining
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Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews
Medicare Advantage Hierarchical Condition Categories: Targeting Chart Reviews Identifying and submitting ... months of 2012. n Health Watch | JANUARY 2011 | 17 Key Methodological Considerations Please note the ...- Authors: Corey Berger, Eric P Goetsch
- Date: Jan 2011
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Demography; Health & Disability>Health risks; Modeling & Statistical Methods>Data mining; Social Insurance>Medicare; Technology & Applications>Analytics and informatics
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Health Watch, November 2016, Issue 81
health actuaries. This year’s event was held June 15–17 at the Marriott Downtown in Philadelphia. The meeting ... security system.”12 NOVEMBER 2016 HEALTH WATCH | 17 Warnings and implications of adverse selection are ...- Authors: Society of Actuaries
- Date: Nov 2016
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions>Actionable recommendations; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Public Policy; Public Policy
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Health Watch, Issue 79, December 2015, Health Watch
gov/pubmed/22361992. 4 http://healthaff airs.org/blog/2015/02/17/in-the-debate-about-cost-and-eff icacy- pcsk9-i ... With Cancer Coverage 20 8% 11% 30 11% 13% 40 17% 24% 50 20% 24% 60 20% 24% Approximate Percentage ...- Authors: Society of Actuaries
- Date: Dec 2015
- Competency: Communication>Written communication; External Forces & Industry Knowledge; Leadership>Influence; Professional Values>Ethical standards; Relationship Management>Team leadership; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Health Watch
- Topics: Experience Studies & Data>Disability; Health & Disability>Critical illness insurance; Health & Disability>Health care; Health & Disability>Health insurance; Health & Disability>Health risks; Modeling & Statistical Methods>Modeling efficiency; Modeling & Statistical Methods>Regression analysis; Technology & Applications>Computer science
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Health Watch, Issue 72, May 2013
truncating large claims. Health Watch | May 2013 | 17 ContInUEd on page 18 The twin goals of the AQC ... Health Watch Massachusetts payment … | froM page 17 moved to network-based trends, the health status ...- Authors: Society of Actuaries
- Date: May 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models
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Health Watch Issue 73, October 2013
condition. The Health Watch | October 2013 | 17 COnTInUEd On page 18 “The ACA risk adjustment ... Health Watch Nontraditional Variables … | frOm page 17 You may already be thinking (correctly I might ...- Authors: Karen Perry, Society of Actuaries
- Date: Oct 2013
- Competency: Results-Oriented Solutions>Actionable recommendations
- Publication Name: Health Watch
- Topics: Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Payment models